Violent injury predicts poor psychological outcomes after traumatic injury in a hard-to-reach population: an observational cohort study
Rahtz, E; Bhui, K; Smuk, M; et al.Hutchison, I; Korszun, A
Date: 1 May 2017
Article
Journal
BMJ Open
Publisher
BMJ Publishing Group
Publisher DOI
Abstract
Background: People who experience physical trauma
face a range of psychosocial outcomes. These may be
overlooked by busy clinicians. While some risk factors are
understood, understanding of the psychological effects of
violent injury remains limited, particularly in UK settings.
This study compared psychological outcomes ...
Background: People who experience physical trauma
face a range of psychosocial outcomes. These may be
overlooked by busy clinicians. While some risk factors are
understood, understanding of the psychological effects of
violent injury remains limited, particularly in UK settings.
This study compared psychological outcomes following
interpersonal violence and accidental injury, including the
persistence of psychological distress.
Methods: A questionnaire survey was carried out at
two time points of patients admitted to a large teaching
hospital in London between July 2012 and April 2014.
Participants were consecutive adult patients admitted to
the Royal London Hospital with traumatic injuries, with 219
participants at baseline. Follow-up survey was 8 months
later (n=109). Standardised measures assessed posttraumatic
stress symptoms (PTSS) (Acute Stress Disorder
Scale and PTSD Checklist) and depressive symptoms
(Hospital Anxiety and Depression Scale).
Results: PTSS and depressive symptoms affected 27%
and 33%,respectively, at baseline. At 8 months, 27% and
31% reported these symptoms for PTSS and depressive
symptoms, respectively. The repeated measures
were assessed with multilevel models: after adjusting
for demographic factors, patients with violent injury
showed more PTSS (OR 6.27, 95%CI 1.90 to 20.66) and
depressive symptoms (OR 3.12, 95%CI 1.08 to 8.99).
Conclusions: There were high levels of psychological
distress among traumatic injury patients. Violent injuries
were associated with an increased risk of both posttraumatic
and depressive symptoms. People vulnerable
to distress would benefit from psychological support,
and hospital admission provides a unique opportunity to
engage hard-to-reach groups in interventions.
Institute of Health Research
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